Respiratory Co-infections with COVID-19 in the Veterans Health Administration, 2020

Schirmer, P; Lucero-Obusan, C; Sharma, A; Sohoni, P; Oda, G; Holodniy, M

Reporting of COVID-19 co-infections with other respiratory pathogens has varied. We evaluated 825,280 molecular/viral culture respiratory assays within the Veterans Health Administration from 9/29/2019-5/31/2020. SARS-CoV-2 was detected in 10,222 of 174,746 (5.8%) individuals. 30,063 (17.2%) of 174,746 individuals tested for SARS-CoV-2 had additional respiratory pathogen testing; co-infection was identified in 56 of 3,757 (1.5%) individuals positive for SARS-CoV-2. Among those negative for SARS-CoV-2, 1,022 of 26,306 (3.9%) were positive for at least one respiratory pathogen. Compared to COVID-19 mono-infection, individuals with COVID-19 co-infection had lower odds of being female. Compared to non-COVID-19 respiratory pathogen infection, individuals with COVID-19 co-infection had lower odds of being female, were hospitalized more frequently, had higher odds of death, and were younger at death. Our findings suggest COVID-19 co-infections were rare; however, not all COVID-19 patients were concurrently tested for other respiratory pathogens and seasonal decreases in other respiratory pathogens were occurring as COVID-19 emerged.